<status value="draft" /> <date value="2021-05-07T12:07:40.5574678+00:00" /> <publisher value="OMD" /> <description value="Proposed constraints on the Observation Resource for general use" /> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166" /> <code value="CA" /> <display value="Canada" /> </coding> <coding> <system value="http://loinc.org" /> <version value="T1" /> <code value="183747" /> <display value="DHL" /> <userSelected value="false" /> </coding> </jurisdiction> <fhirVersion value="4.0.1" /> <mapping> <identity value="CDSS5.1" /> <uri value="www.ontariomd.com" /> <name value="CDS-S 5.1" /> </mapping> <kind value="resource" /> <abstract value="false" /> <type value="Observation" /> <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Observation" /> <derivation value="constraint" /> <differential> <element id="Observation"> <path value="Observation" /> <short value="Observation Profile" /> <definition value="The Observation Profile is based upon the core FHIR Observation Resource" /> </element> <element id="Observation.status"> <path value="Observation.status" /> <definition value="BASE RESOURCE DEFINITION: The status of the result value. CDS-S PROFILE DEFINITION: The status of the results as provided by the source." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE10.013" /> <comment value="Test Results Status" /> </mapping> </element> <element id="Observation.category"> <path value="Observation.category" /> <mustSupport value="true" /> </element> <element id="Observation.code"> <path value="Observation.code" /> <comment value="The binding strength of this element is [Preferred](https://www.hl7.org/fhir/terminologies.html#strength), meaning that codes are encouraged to draw from the LOINC code system for interoperability purposes but are not required to do so to be considered conformant. *All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation." /> <mustSupport value="true" /> <binding> <strength value="preferred" /> <description value="LOINC codes identifying names of simple observations." /> </binding> </element> <element id="Observation.code.coding.system"> <path value="Observation.code.coding.system" /> <fixedUri value="http://loinc.org" /> </element> <element id="Observation.code.coding.code"> <path value="Observation.code.coding.code" /> <code> <system value="http://loinc.org" /> <code value="8992-5" /> <display value="FEV" /> </code> <code> <system value="http://loinc.org" /> <code value="8573-3" /> <display value="FVC1" /> </code> <code> <system value="http://loinc.org" /> <code value="19925-3" /> <display value="FEV1/FVC1" /> </code> </element> <element id="Observation.subject"> <path value="Observation.subject" /> <min value="1" /> <type> <code value="Reference" /> <targetProfile value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-patient" /> </type> <mustSupport value="true" /> </element> <element id="Observation.effective[x]"> <path value="Observation.effective[x]" /> <type> <code value="dateTime" /> </type> <type> <code value="Period" /> </type> <mustSupport value="true" /> </element> <element id="Observation.value[x]"> <path value="Observation.value[x]" /> <slicing> <discriminator> <type value="type" /> <path value="$this" /> </discriminator> <rules value="open" /> </slicing> <constraint> <key value="ca-baseline-value-1" /> <severity value="error" /> <human value="Observation.value[x] or Observation.dataAbsentReason or Observation.component SHOULD be present" /> <expression value="value[x].exists() or dataAbsentReason.exists() or component.exists()" /> <xpath value="Observation.value[x] or Observation.dataAbsentReason or Observation.component" /> <source value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation" /> </constraint> <mustSupport value="true" /> </element> <element id="Observation.value[x]:valueQuantity"> <path value="Observation.value[x]" /> <sliceName value="valueQuantity" /> <type> <code value="Quantity" /> </type> </element> <element id="Observation.value[x]:valueQuantity.unit"> <path value="Observation.value[x].unit" /> <definition value="BASE RESOURCE DEFINITION: A human-readable form of the unit. CDS-S PROFILE DEFINITION: Unit of measure associated with the test result as provided by the source." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE10.008" /> <comment value="Result Unit of Measure" /> </mapping> </element> <element id="Observation.dataAbsentReason"> <path value="Observation.dataAbsentReason" /> <constraint> <key value="ca-baseline-value-1" /> <severity value="error" /> <human value="Observation.value[x] or Observation.dataAbsentReason or Observation.component SHOULD be present" /> <expression value="value[x].exists() or dataAbsentReason.exists() or component.exists()" /> <xpath value="Observation.value[x] or Observation.dataAbsentReason or Observation.component" /> <source value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation" /> </constraint> <mustSupport value="true" /> </element> <element id="Observation.dataAbsentReason.coding.code"> <path value="Observation.dataAbsentReason.coding.code" /> <definition value="BASE RESOURCE DEFINITION: A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). CDS-S PROFILE DEFINITION: Indicates whether the test result is considered sensitive information." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE10.022" /> <comment value="Blocked Test Result" /> </mapping> </element> <element id="Observation.interpretation.text"> <path value="Observation.interpretation.text" /> <definition value="BASE RESOURCE DEFINITION: A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. CDS-S PROFILE DEFINITION: Flag to indicate a test result is deemed normal, abnormal, unkown or as provided by the source." /> <mustSupport value="true" /> <binding> <strength value="required" /> <description value="Refer to CT-029: Laboratory AbnormalFlag" /> <valueSet value="https://simplifier.net/guide/CoreDataSetStandardCDS-SImplementationGuidance/ReportsFlagsDataTypesCodeTablesCT-027toCT-038" /> </binding> <mapping> <identity value="CDSS5.1" /> <map value="DE10.012" /> <comment value="Abnormal Indicator" /> </mapping> </element> <element id="Observation.note.text"> <path value="Observation.note.text" /> <definition value="BASE RESOURCE DEFINITION: The text of the annotation in markdown format. CDS-S PROFILE DEFINITION (Patient Demographics): Additional notes about the patient. CDS-S PROFILE DEFINITION (Laboratory Test Results - Lab Notes): Notes associated with an individual test result as provded by the source. CDS-S PROFILE DEFINITION (Laboratory Test Results - Physician Notes): Notes associated with an individual test result as typed in by a physician in the EMR." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE01.023" /> <comment value="Patient Note" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE10.016" /> <comment value="Lab Notes" /> </mapping> <mapping> <identity value="CDSS5.1" /> <map value="DE10.017" /> <comment value="Physician Notes" /> </mapping> </element> <element id="Observation.referenceRange.low"> <path value="Observation.referenceRange.low" /> <definition value="BASE RESOURCE DEFINITION: The value of the low bound of the reference range. The low bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the low bound is omitted, it is assumed to be meaningless (e.g. reference range is <=2.3). CDS-S PROFILE DEFINITION: The lower range limit associated with a test as provided by the source." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE10.009" /> <comment value="Reference Range Low" /> </mapping> </element> <element id="Observation.referenceRange.high"> <path value="Observation.referenceRange.high" /> <definition value="BASE RESOURCE DEFINITION: The value of the high bound of the reference range. The high bound of the reference range endpoint is inclusive of the value (e.g. reference range is >=5 - <=9). If the high bound is omitted, it is assumed to be meaningless (e.g. reference range is >= 2.3). CDS-S PROFILE DEFINITION: The upper range limit associated with a test as provided by the laboratory." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE10.010" /> <comment value="Reference Range High" /> </mapping> </element> <element id="Observation.referenceRange.text"> <path value="Observation.referenceRange.text" /> <definition value="BASE RESOURCE DEFINITION: Text based reference range in an observation which may be used when a quantitative range is not appropriate for an observation. An example would be a reference value of "Negative" or a list or table of "normals". CDS-S PROFILE DEFINITION: The reference rage that cannot be depicted numerically or cannot be parsed as high and low reference range provided by the source." /> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE10.011" /> <comment value="Reference Range (Text Based)" /> </mapping> </element> <element id="Observation.component.code"> <path value="Observation.component.code" /> <comment value="The binding strength of this element is [Preferred](https://www.hl7.org/fhir/terminologies.html#strength), meaning that codes are encouraged to draw from the LOINC code system for interoperability purposes but are not required to do so to be considered conformant. *All* code-value and, if present, component.code-component.value pairs need to be taken into account to correctly understand the meaning of the observation." /> <mustSupport value="true" /> <binding> <strength value="preferred" /> <description value="LOINC codes identifying names of simple observations." /> </binding> </element> <element id="Observation.component.value[x]"> <path value="Observation.component.value[x]" /> <definition value="BASE RESOURCE DEFINITION: The information determined as a result of making the observation, if the information has a simple value. CDS-S PROFILE DEFINITION: The numeric or qualitative results of a test as provided by the source." /> <constraint> <key value="ca-baseline-value-2" /> <severity value="error" /> <human value="Observation.component.value[x] or Observation.component.dataAbsentReason SHALL be present" /> <expression value="component.value[x].exists() or component.dataAbsentReason.exists()" /> <xpath value="Observation.component.value[x] or Observation.component.dataAbsentReason" /> <source value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation" /> </constraint> <mustSupport value="true" /> <mapping> <identity value="CDSS5.1" /> <map value="DE10.007" /> <comment value="Result Value" /> </mapping> </element> <element id="Observation.component.dataAbsentReason"> <path value="Observation.component.dataAbsentReason" /> <constraint> <key value="ca-baseline-value-2" /> <severity value="error" /> <human value="Observation.component.value[x] or Observation.component.dataAbsentReason SHALL be present" /> <expression value="component.value[x].exists() or component.dataAbsentReason.exists()" /> <xpath value="Observation.component.value[x] or Observation.component.dataAbsentReason" /> <source value="http://hl7.org/fhir/ca/baseline/StructureDefinition/profile-observation" /> </constraint> <mustSupport value="true" /> </element> </differential> </StructureDefinition>